Crohn’s Complications: How to Soothe a Sore Behind

You may not want to talk about it in polite company, but if you have an IBD like Crohn’s disease, diarrhea is an all-too-familiar problem for you. Persistent, urgent diarrhea is one of the classic signs of Crohn’s disease, according to the Crohn’s and Colitis Foundation.

The reason people with Crohn’s suffer from frequent diarrhea is that “the cells in the intestinal lining that normally absorb water are damaged, and as a result, stools have more liquid,” says Louis Cohen, MD, gastroenterologist and assistant professor of medicine at the Icahn School of Medicine at Mount Sinai Hospital in New York City. “At the same time,” he adds, “inflammation damages nerves and muscles that control the contractions and sensations of a normal bowel movement” which creates looser stools, and greater urgency and frequency.

All those trips to the bathroom and constant wiping can irritate your skin and may lead to more troublesome complications, such as anal fissures, says Dr. Cohen. Fissures, small tears in the muscles of your anus, make it even harder to clean properly after a bowel movement.

Relieve the Diarrhea

Your first step to relief is to try to limit episodes of diarrhea. Over the counter anti-diarrheal medication can be useful, says Cohen. But ask your gastroenterologist for advice before taking one, to be sure it won’t interfere with your Crohn’s medication. Also remember that anti-diarrheals ease or mask symptoms; they don’t treat the underlying cause of the diarrhea.

Dietary changes can also help control diarrhea. Some Crohn’s sufferers find that limiting irritants, like caffeine, fatty and spicy foods, lactose (dairy), certain high fiber foods, alcohol, and any other items that you know are triggers, can help.

A whole host of diets purport to help control Crohn’s symptoms. One is the so-called “low residue” diet. By eliminating whole grains, dairy, and all fruits and vegetables save bananas and potatoes (without skin), it aims to reduce the frequency and volume of bowel movements, which would in theory reduce incidence of diarrhea. A review published in March 2017 in the journal Nutrition looked at a range of diets used to control IBD and found that a low-residue diet is frequently used but not fully supported by the evidence.

Treating Your Behind

Sometimes you can’t avoid bouts of diarrhea, and that can irritate the skin. Here’s how to treat and help prevent this painful issue:

Clean carefully. After you go, use moist wipes, such as flushable wipes or baby wipes (just be sure they’re fragrance- and alcohol-free), rather than dry toilet paper, says Cohen.

Skip harsh soap. When you shower or bathe, rinse the area with warm water and only mild or no soap. Pat dry without rubbing or allow to air-dry.

Try a sitz bath. Sit for 15 minutes in a shallow bath of lukewarm water.

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